Since the discussion of some of the NYC programs and Cornell vs. Columbia has come up, I thought I might add my two cents.
Residents:
Cornell: All of the residents were extremely friendly, seemed to have great rapport and a "have each other's backs" attitude. There was more than one instance when residents were getting hammered on call overnight and residents on other services would help out on their own accord. The team structure was very non-hierarchical, with it almost difficult to tell just based on interactions who was chief and who was intern.
Columbia: Definitely more of a "suck up and deal" attitude rather than "got your back". Residents seemed tired and overworked, with frequent tiffs between residents. Likely a reflection of the enormous workload in a hospital that makes everything more difficult. Unlike Cornell where the chiefs would tell students to come in, get the vitals and lets all round together, Columbia subI's were coming in as early as 4:30am (some earlier) and were expected to finish all the notes before the chief came, and weren't even given weekends off. Atmosphere definitely seemed not very collegial.
Leadership:
Cornell: The residents seemed to have a great relationship with the administration, especially the Chair and PD. The chair had weekly rounds, regularly held meetings with the residents, organized and conducted M&M etc. gestures I saw as indications of his commitment to the surgical program. Cornell is also starting their own liver transplant division, and I know the chair is instrumental in that. He also seems to command a great deal of respect both within the dept. as well as elsewhere (president of Society for Surg.Onc etc). Moreover, he is the nicest guy, an absolute gentleman and one of the most humble surgeons I have met given his prominence in the field of academic surgery.
The PD also seemed to have a great rapport with the residents, hanging out with them in the lounge, joking, and so on. His weekly topic discussions were a reflection of the laid back nature of their interactions, and this was evident to those who saw him at the bar night before interview day.
Although the hospital is supposedly run like a private hospital, it did not seem as if all attendings treated their patients like private patients. There were numerous instances where the chief was allowed to start complex cases with junior residents and the attending would show up hours later just to help out with the anastamosis and leave, with MSIV's regularly doing the opening and closing. OR teaching was overall great, with focus not just on technical details but possible complications, current treatment modalities and trials and so on.
Columbia: The fact that the chair doesn't come to any of the general surgery interviews, is completely uninvolved with the program (as per residents and info on interview day) and the ONLY attending addressing the candidates was the PD (who is likely going to retire in a few years) was discouraging. Some of the attendings I spoke to openly disclosed their discontent with the administration and because of this, said most attendings are apathetic towards teaching residents. This seemed to agree with some other info on Columbia attendings being unhappy eg: the numerous vascular attendings who recently left for St. Luke's. MSIV's also spent entire months on service without even doing a single closure.
Cornell's night before almost everyone who could including the PD and another attending showed up. Columbia's night before turnout mostly limited to interns (some who were ortho and stuff), NO CHIEFS!! On interview day, whereas Cornell seemed vibrant, lots of people enthusiastic about the place, Columbia seemed empty the presentation to the interviewees was done by a chief resident (not even an attending!), and apart from her (who was likely asked by the PD to do it), there were NO SENIORS/CHIEFS AROUND to talk about their experiences nor were there any attendings apart from the PD and maybe two others. If you like your program, you should be enthusiastic about it and show up to sell it. It was a hard sell if the only residents tooting it were interns. Many of the interviewees echoed similar feelings (check out locitamd's post on interview experiences on Columbia).
Fellowships:
Cornell: Check them out yourself:
http://www.cornellsurgery.org/resid...reer+Paths+of+Program+Graduates&type1=2Active
Great programs and a variety of specialties represented, including plastics matches at UCSF, NYU (2004), cornell/columbia, CT at MGH, WashU, Surg Onc at Memorial sloan, MDAnderson, transplant at UCSF and UPitt. Great fellowships = other programs must consider cornell residents very highly + cornell must have very supportive administration to get residents to where they want to be + the deal on "cornell residents don't operate" must be bogus as obviously other institutions hold them in high regard.
Columbia: Check it out:
http://www.columbiasurgery.org/residency/graduates.html
Not as broad representation of specialties (very heavy CT, Tranplant), almost no plastics, very few onc with only 2 onc. fellowship in over 10 years (one which was breast). Even all the CT, transplant fellowships heavily matching at Columbia. I didn't like that fact that Columbia residents weren't venturing out for even CT and Tranplant fellowships, areas they are supposed to be better in. And if they are better than cornell in these specialties, why was I seeing CT at MGH, WashU and transplant at UCSF and Univ. of Pitt on Cornell's fellowship matches, but none of these for Columbia?
One area Columbia is likely stronger in is peds, with consistently very good fellowship matches and most likely a better peds surg experience by having a childrens hospital.
Location: Cornell, great location, great housing, nothing beats rolling out of bed into the hospital, home call a great plus. Columbia location is horrible so even with subsidized housing, not a great location to live by any means. And although most residents live on the upper west side, commuting even 20mins can be extremely painful in NYC, especially going back in the evening. Also, considering Columbia's long hours, waking up at 4:00am (or earlier) to make that extra 20 min commute didn't seem appealing to me.
Training/OR experience: Columbia likely slightly more OR heavy than Cornell, but Cornell likely better all around training with better ICU rotations and so on. Also, I don't think making a good surgeon depends solely on the sheer number of cases you log as a resident. This in itself is a separate discussion but I think most would agree it is a mix of a lot of things. Cornell seemed to have all of it, with good operative numbers, good breadth of cases, great research opps, good didactics, great faculty, great residents and so on. Columbia, although anecdotally was supposed to have lots more operative exposure for residents, the seniors and chiefs were not terribly impressive in terms of operative skills (eg: fourth year residents holding single laparoscopic instruments with two hands). The lack of ICU experience at Columbia (I think only 2 months as a 2nd year) was evident in the billion consults for every little thing (plus questions to MSIV's such as "What is Plavix?"). The didactics also didn't seem highly academic, with not much emphasis of recent trials, new treatment modalities and so on.
OR volumes at Cornell had been criticized for being low. I found that the average cases logged by Cornell chiefs ranged from 850-1000 cases and these were the same numbers advertised by other big academic institutions such as MGH and Brigham on their interview days. I definitely don't believe the 1500 cases logged by Columbia chiefs. In city programs such as NYC, Boston where competition for cases is higher and fellowships exist, such numbers I don't think are possible anywhere - especially at Columbia considering poor ancillary facilities at Milstein. So my feeling was case load at Cornell was comparable to any other academic city program and the rumours on the trail were likely just that very much like the "NYU is malignant" rumour which I know is completely unfounded.
I think most of your impressions of an institution depend on personal experiences so go with your gut. I think that among all the top institutions, there virtually is no difference and its just a matter of where you fit in. However, no matter how good a program is, it is not going to make you a good surgeon if you are miserable, hate the people you work with, are unmotivated and wish you were somewhere else. That being said, here's my list:
1. Cornell
2. Brigham
3. MGH
4. WashU
5. UCSF
6. UCLA
7. Hopkins
8. UPenn
9. NYU
10. Mt. Sinai
11. Columbia
